PPH

Call for help-

Other midwives

senior midwives

obc consultant or reg

anethetist

Assess- 

tone- atonic? Fundal massage

tissue- are the placenta membranes complete? could retained membranes be causing a bleed?

trauma- check for tears externally and internal- vaginal wall? cervial tear?

tissue- thrombin indication. check for clotting

Insert IDC

Fundal massage

Bimanual massage is needed

Insert 2 x 16g cannulas- take bloods

FBC, crossmatch x 4, u&e, clotting and rotem if available

Observations- HR…